Platelet Rich Plasma (PRP) for Orthopedic Problems

Orthopedic PRP injections are commonly done in those with joint, tendon, tendon sheath, ligament, cartilage, chronic sprain and/or arthritis issues. Common reasons for injecting PRP include arthritis in a joint, tendon damage, ligament rupture, tendinitis, nerve injuries, tennis elbow, rotator cuff shoulder problems, knee arthritis, chronic ankle sprains and many more. Results are usually good by 12 weeks.

Small areas of injury such as a tennis elbow often do well with just one injection. Chronic arthritic conditions often require 2-3 treatments for best results. Goals for a milder problem often include complete relief of symptoms. For advanced arthritis a 50-75% reduction in pain and avoiding a joint replacement surgery may be a reasonable goal. Very severe problems such as bone on bone arthritis requiring a total knee replacement can often be helped and PRP injections are now considered an alternative to total knee replacement in some patients. However, arthritis pain reduction results are not nearly as good with severe arthritis as with milder disease. PRP injections are commonly given in conjunction with surgery, such as rotator cuff surgeries or knee ligament repairs. Insurance still does not usually cover PRP orthopedic injections, but this is changing.

The injection process:
the types and sizes of needles used and skin cleansing used for other orthopedic injections, such as Kenalog injections, are similar with PRP. However, with orthopedic PRP injections no lidocaine is added to the injection material and there is an increase in pain after injection, typically moderate. Most pain is gone within 2 hours. Some patients have mild pain in the area for a day or two. A sensation of fullness in the injected area is common for a few days, such as when Dr. Van Reken injected his own knee and ankle.

Factors affecting results:
clinical results vary depending on medical history, age, prior joint or orthopedic tissue damage, prior surgery, severity of orthopedic damage on imaging studies, clinical severity of orthopedic symptoms, duration of symptoms prior to treatment, compliance with pre and post treatment instructions and individual response to treatment. Patients with orthopedic surgery recently done or to being done soon may have additional benefit and more rapid healing when PRP injections are used in with surgery.